單擊此處編輯母版標題樣式,單擊此處編輯母版文本樣式,第二級,第三級,第四級,第五級,*,*,*,case,Personal information:,1year 8 months old,male,Chief complaint:,edema around the eyes and in the lower extremities for 7 days,seven days prior he parents noticed his periorbital edema,And then lower extremities edema,oliguria,foamy urine,Past Medical History,The second child in his family,Full-term product of an uncomplicated pregnancy,Growth and development normal,No history of hospitalization and surgery,Allergies:None known,Immunizations:Up to date,Family History,No family members with kidney disease,rheumatoid disease,or neoplasia,Social History,Lives with parents in city,No pets or recent travel,PX,weight 12kg BP 90/56 mmHg,edema in lower extremitis and around the eyes,shifting dullness(negative),Heart and lung auscultation is normal,no rash,He is afebrile,Urinalysis,Dipstick,blood negative,protein 4+,specific gravity 1.035,Microscope,RBC negative,WBC negative,Complete blood count,WBC 8.95*109/L,N 47.2%,Hb 129g/L,Plt 371*109/L,CRP1mg/L,Primary diagnosis?,Further examinations?,Further examinations,ESR 77mm/h,Serum albumin 13.8g/L,Serum cholesterol 3.03 mmol/L,Serum triglyceride 9.77 mmol/L,Protein/creatinine ratio 3.72,Total urine protein 2081mg/24hr,TORCH negtive,ANA negtive,PPD test negtive,Completment 3 level and serum creatinnine normal,X ray:normal,Ultrasonography:normal,Most likely diagnosis,nephrotic syndrome,(NS),Treatment,Low-sodium diet,Diuresis:Spironolactone and hydrochlorothiazide,Iv albumin 10g,Steroid:methylprednisolone 16mg/d iv for 10days-,then prednisone 10mg bid po,Case report,4 days later:edema remission,11days later:urine protein（-）,Thank you,。